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Smartphones Are Driving Clinical Transformation
Session #81, February 12, 2019
Howard Landa MD, VP of Clinical Informatics, Sutter Health
Gregg Malkary, Managing Director, Spyglass Consulting Group
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Gregg Malkary, Managing Director, Spyglass Consulting Group
Has no real or apparent conflicts of interest to report.
Howard Landa MD, VP of Clinical Informatics, Sutter Health
Has no real or apparent conflicts of interest to report.
Conflict of Interest
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• Examine
– Limitations of existing clinical processes & tools
• Identify
– Why hospitals focused on enterprise-wide deployments
• Analyze
– How Smartphones are driving clinical transformation
• Explore
– Future Smartphone growth opportunities
Agenda
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• LO1: Define what smartphone-based unified communications is and how
hospitals are using these solutions to achieve Quadruple Aim and potential
ROI models to justify large scale investments
• LO2: Identify how smartphone-based communications are driving clinical
transformation and can address mission- and patient-critical
communications requirements of clinical and non-clinical mobile workers
• LO3: Recognize how to address and overcome the associated pitfalls in
operationalizing a large-scale health system-wide deployment across
different care settings
• LO4: Discuss future growth opportunities integrating solutions with
evidence-based clinical pathways and care management programs
including support of bedside documentation and clinical surveillance
• LO5: Recognize how hospitals can leverage an evidence-based approach
using RTLS; intelligent rules-based engine and predictive analytics to
reduce alert, alarm and notification fatigue at point of care
Learning Objectives
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• Conducted
– Nationwide end user market study
• Interviewed
– 400 US-based thought leaders
• Explored
– Clinical communications inefficiencies
– Mobile communications usage models
– Barriers for widespread adoption
• Footnote
Spyglass Consulting, Trend in Clinical Communications & Collaboration, 2018
Research Methodology
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Market Opportunity
• US Dept of Labor Statistics
– 950K physicians, 3M RNs, 5M allied professionals
• Joint Commission
– Root cause of 70% treatment delays & sentinel events
• Caused by breakdown in communications
• Hospital IT imperative
– Evaluate next generation communication solutions
• Footnotes
US Dept of Labor Statistics, 2019, https://www.bls.gov/
Joint Commission, Sentinel Event Alert and Infographic, Sept 2017
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Communications Problems
Communications
Overload
Lack of standardized
processes
Antiquated tools
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Enterprise-Wide Deployments
• Deployed
– 47% large-scale Smartphone deployments
• Identified
– 48% compelling ROI models
• Evaluating
– 62% mobile documentation tools
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Mobile EHR Messaging Tools
• Ease of support
• EHR integration
• Clinical workflow integration
• Attractive licensing
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Clinical Transformation
• Developed
– 73% mobile technology strategies
• Leveraged
– 68% middleware to orchestrate patient care
• Optimized
– 64% clinical workflow processes to support
patient centered care models
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• Optimized
– 89% wireless network for mobile voice and
data
• Deployed
– 73% MDM solutions to protect hospital
assets and data
• Expanded
– 93% BYOD programs to support mobile
workers
Infrastructure Upgrades
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Emerging Opportunities
• Structured clinical communications
• Real-time location services (RTLS)
• Real-time clinical surveillance
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HOWARD LANDA MD
VP OF CLINICAL INFORMATICS
SUTTER HEALTH
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Howard Landa, MD
• Pediatric GU/Clinical Informatics for > 20 years
• Vice President of Clinical Informatics
• Sutter Health
– 24 Acute Hospitals,
– 12000+ Physicians
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CMIO’s perspective
Clinical Collaboration at Scale
• Healthcare Technology in Evolution
• Current Clinical State
• IT Challenges
• Communication Integration
• Emerging opportunities
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Healthcare Technology in Evolution
• EHR evolution
– Documentation (Electrified paper/word processor)
– Communication/Reference
– Information/Decision SupportClinical transformation
• Care/Reimbursement Evolution “In the day” vs. Today
Single physician Team based care
Always available Complex/Varying Schedules
LOS as needed Discharge ASAP
Pagers/Desk phone EHR, Texting, HIE Mobility
Simple Alerts Complex Alert Management
Limited tools set Complex and Evolving Tech…
But Smartphones are ubiquitous
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Smartphone-based communications are supporting current
but provide opportunities to transformation practice
Insecure Texting/Tools
The (other) elephant in the room
Difficult to monitor and control
Efficient and straightforward
EHR
Standard for clinical information
Support of workflow and clinical process transformation
Mobility
Secure texting
Promises, Promises (Panaceas?)
CCC: Current clinical state
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Real Challenges for IT
• Security is another major challenge
• Organizational vs BYOD
– Bandwidth / Support / Security
– Human Resource issues
• How many is too many?
• Size does matter (with respect to use case)
• Benefits, Real and Imagined
– Communication/Information/Workflow
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CCC Integration
• Integration is how communication evolves to tools that
support the quadruple aim.
• Use(full?) cases
– Stand alone (Communication, Reference)
– Interfaced (Information, Alerts)
– Integrated (Workflow tool)
– Assimilated (Camera, Voice Recognition, Adjunct)
• Organizational size and complexity are both
challenges and opportunities
• Somewhere in the Middle(ware)
– Alarm Management Clinical Decision Support (CDS),
– Is secure chat + EHR mobile app Middleware?
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Emerging Opportunities
• Healthcare Technology in
Evolution
• Current state
• IT Challenges
• Communication
Integration
• Early adopter,
Mainstream or Laggard
• Strategy (HW/SW)
• Leveraging Size and
complexity challenges
New technology to support integrated clinical workflows,
surveillance, evidence-based pathways and bedside care
management:
AI/ML, RPM, PROM, NLP, “One Ring”
IOT: RTLS, Visual, Spatial (Gyro), Haptics
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Conclusions
• Hospital IT imperative
– Evaluate next generation comm solutions
• Hospital IT making significant investments
– Purchasing large quantities of Smartphones
– Deploying mobile unified communications
– Optimizing workflow processes
• Hospital IT addressing operational challenges
